What are the deleterious effects of taking pain medication

Painkiller : Dangerous in the long run

They are called "Painkillers" in the USA, where you can buy them in large quantities in every drugstore. In German-speaking countries, the per capita consumption of painkillers is lower, but active ingredients such as acetylsalicylic acid (ASA), paracetamol, ibuprofen and diclofenac can be found in most home pharmacies. For headache and joint pain or flu-like infections The “doctor” who “prescribes” the medication is usually the person suffering from pain or a helpful family member. Taking them in low doses and for a few days is harmless and free of side effects.

Experts are calling for the amounts of over-the-counter pain relievers to be limited. As has been the case with paracetamol since April 2009. Since then, pharmacists have been allowed to sell a maximum of ten grams of the product if the customer does not have a doctor's prescription. Because paracetamol is poison for the liver in high doses. In the United States, 500 people die each year from overdose, whether intentional or unintentional. In Germany, 4184 intoxications with paracetamol were reported to the poison information centers in 2006, the majority of them after a suicide attempt. Because paracetamol not only relieves pain, but also lowers fever, it is a popular drug for children, usually in low doses in suppository form. "In individual cases we have seen poisoning by paracetamol in children," warns Ulrich Schwabe from the Pharmacological Institute at Heidelberg University. For adults, as little as ten grams, taken at once with alcohol, could be fatal. Because of these risks, Schwabe welcomes the sales restrictions; he would set them even lower.

In his opinion, it is high time to set stricter rules for drugs from the group of non-steroidal anti-inflammatory drugs, which include aspirin, ibuprofen and diclofenac. "Because there is no quantity restriction here, the impression could arise that they are less harmless than paracetamol." An impression that is at best true if one classifies the agents according to their suitability for attempted suicide. However, the anti-inflammatory pain relievers also have a fatal risk: if they are taken continuously, they can cause severe gastric bleeding. There is also a risk of kidney damage, especially in older people, if their kidney function is already impaired. In addition, there is a seemingly paradoxical problem of long-term use: the headache caused by headache pills.

Experts like Schwabe are urging that these pain relievers are only sold in quantities that last for four days. The Committee of Experts for Prescription Requirements at the Federal Institute for Drug Safety (BfArM) will discuss this at the beginning of the new year. It is the second attempt after the body made up of doctors and representatives from pharmaceutical companies rejected an application in September. The BfArM says that further data is to be presented to him, for example from the poison control centers and from a study from England that proves the advantages of small packages.

It is hoped that the committee will set sales limits not only for diclofenac, ibuprofen and ASA, but also for phenazone and propyphenazone. "We believe that taking non-steroidal anti-inflammatory drugs beyond four days is associated with risks that patients cannot recognize," says BfArM spokeswoman Eva Schulz. The industry must take this into account by adapting the pack sizes.

If all common painkillers were only available in low doses and small quantities, awareness of their dangerous side effects would increase, hopes pharmacologist Schwabe. A point of view shared by two important pharmacist committees. In a joint statement in November 2010, the Drugs Commission of German Pharmacists and the German Pharmaceutical Society came out in favor of defining maximum pack sizes. It should prevent the "uncritical and excessive use of these drugs". "In principle, analgesics available without a prescription should not be taken for longer than three to four days and no more than ten days per month without medical advice," says the paper.

"We convey this again and again in the consultation in the pharmacy," adds Ursula Sellerberg, spokeswoman for the Federal Association of German Pharmacists' Associations (ABDA). If you visit several pharmacies in a row to buy larger quantities of painkillers without a prescription, you have to put up with more warning words under these circumstances.

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